Coexistence of high visceral fat area and sarcopenia is associated with atherosclerotic markers in old-old patients with diabetes: A cross-sectional study

Aims/IntroductionTo investigate whether sarcopenic obesity is associated with the progression of atherosclerotic lesions in older patients with diabetes and to identify the obesity components of sarcopenic obesity that best reflect atherosclerosis.Materials and MethodsIn 118 inpatients aged >= 75 years with diabetes mellitus, sarcopenia defined as a low skeletal muscle mass and low grip strength was assessed, and sarcopenia coexisting with a high body-fat percentage or visceral fat area was defined as sarcopenic obesity. Correlations between the obesity components and atherosclerotic markers, including the carotid intima-media thickness, were analyzed; the intima-media thickness was analyzed in four groups with and without obesity and sarcopenia, and a multiple linear regression analysis adjusted for covariates was conducted to investigate whether sarcopenic obesity was independently associated with the intima-media thickness.ResultsThe visceral fat area and intima-media thickness showed positive correlations in the overall patients (P = 0.032) and the sarcopenia (P = 0.016) group but showed no associations in participants without sarcopenia. The intima-media thickness in the group showing sarcopenia with a high visceral fat area was significantly higher than that in the control group (P = 0.012). Sarcopenic obesity defined by a high body-fat percentage and high visceral fat area was independently associated with the intima-media thickness even after adjusting for age, sex, and atherogenic risk factors. However, sarcopenic obesity defined by a high visceral fat area was more strongly associated with the intima-media thickness (beta = 0.384, P = 0.002) than that defined by the high body-fat percentage (beta = 0.237, P = 0.068).ConclusionsSarcopenic obesity, especially that defined by visceral fat accumulation, reflected the risk of atherosclerotic lesion progression in older patients with diabetes. To investigate whether sarcopenic obesity is associated with the progression of atherosclerotic lesions, the carotid intima-media thickness (IMT) was measured in older patients with diabetes mellitus aged >= 75 years. When divided into four groups according to the presence of sarcopenia and obesity defined by the visceral fat area, IMT was significantly higher in the group with sarcopenia and obesity defined by a high visceral fat area than in the control group (Figure). Multiple linear regression analysis showed that sarcopenic obesity defined by a high visceral fat area was independently associated with IMT after adjustment for covariates, and the sarcopenic obesity defined by the visceral fat area was more strongly associated with IMT than sarcopenic obesity defined by body fat percentage. Sarcopenic obesity, especially that defined by visceral fat accumulation, reflects the risk of atherosclerotic lesion progression in older patients with diabetes. image